Fig. 1

PTCB for four biliary different sites. Case 1 (A–D), a 59-year-old male, had intrahepatic bile duct obstruction with jaundice. Preoperative enhanced CT coronal view (A) showed intraluminal tumor (arrow) and distal bile duct dilatation; percutaneous cholangiography showed intrahepatic filling defect sign in the hilar and left and right biliary ducts (B, arrow). The biopsy forceps were introduced through the 9F sheath, and the PTCB was completed on the obstruction site (C, circle). The pathological result showed cholangiocarcinoma (D). Case 2 (E–H), a 71-year-old female, had hilar bile duct obstruction. Preoperative MRCP suggested hilar bile duct obstruction (E, arrow) with obvious dilatation of the intrahepatic bile duct; percutaneous cholangiography showed significant stricture of the hilar bile duct (F, arrow), and the position was consistent with preoperative MRCP. The biopsy forceps were introduced through the 9F sheath, and PTCB was completed on the obstruction site (G, circle); the pathological results showed cholangiocarcinoma (H). Case 3 (I–L), a 54-year-old male, had middle extrahepatic bile duct obstruction. Preoperative MRCP (I, arrow) showed extrahepatic middle bile duct obstruction and severe dilatation of the bile duct above the obstruction. Percutaneous cholangiography showed severe obstruction in the middle segment of the bile duct, which coincided with the location of preoperative MRCP (J, arrow). The biopsy forceps were introduced through the 9F sheath, and PTCB was completed on the obstruction site (K, circle); pathological results showed cholangiocarcinoma (L). Case 4 (M–P), a 65-year-old male, had low biliary obstruction. The coronal position of preoperative enhanced CT (M) showed low obstruction of the extrahepatic common bile duct (arrow) and severe dilatation of the bile duct above the obstruction. Percutaneous cholangiography showed severe obstruction of the lower bile duct, which was consistent with the position shown by preoperative enhanced CT (N, arrow). The biopsy forceps were introduced through the 9F sheath, and the PTCB was completed on the obstruction site (O, circle). The pathological result showed pancreatic cancer (P)